Dec. 16, 2003 --
Despite cuts in in-home services such as those proposed in California, nursing home reimbursement rates have remained steady in most cases, according to a report by the General Accounting Office. Of the states studied for its report, "only Illinois, Massachusetts,
Michigan, and Texas cut the per diem rates paid to all nursing homes" during fiscal years
1998 through 2004.
"In over three-quarters of
these states, nursing home per diem rates grew, on average, by an
amount that exceeded the skilled nursing facility market basket index,
the index used by the Centers for Medicare & Medicaid Services to
measure changes in the price of nursing home goods and services for
Medicare."

The GAO report notes that
"almost half of all Americans over the age of 65 will rely on nursing
home care at some point in their lives, and two in three nursing home
residents have their care covered at least in part by Medicaid. Under
Medicaid, states set nursing home payment rates and the federal
government reimburses a share of state spending," says the GAO report.

"According to the most
recently available data, Medicaid nursing home expenditures exceed $43
billion, and total Medicaid spending for fiscal year 2003 is expected
to double by 2012," says the report.

For the report, GAO interviewed state and
nursing home industry officials in 19 states and obtained
documentation about nursing home payment rates and methods, including
state methods to determine nursing home per diem rates for fiscal
years 1998 through 2004. "Although each of the 19 states experienced recent fiscal pressure,
states' nursing home payment rates have remained largely unaffected," reported GAO.